Hand Flapping...Chewing....scripting?
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| Sat, 07-16-2005 - 10:30pm |
Hi. My son is diagnosed with verbal dyspraxia but I suspect at some point he may receive a diagnosis somewhere on the spectrum - maybe PDDNOS or Aspergers along with the dyspraxia. I have a few questions about his quirks.
Hand flapping - Is is always a bad sign? Does anyone have a NT child that did it?
Does it look the way it sounds? My son will flap his hands (not near face though) when he likes a play activity.
Chewing - My son loves to chew on things at age 3 1/2. He will chew on his clothes, pillows or blankets. I offer him a wet washcloth, to meet this need in a slightly more socially acceptable way. I don't know if this could be a spectrum/stimulatory type behavior or if it could be a need for oral stimulation, to strengthen his weak muscles..
Scripting - My son does what I refer to as scripting. He repeats extended segements of books or videos. Again, does anyone have a NT child that did this?
Hyperlexic - Is anyone else's child reading?
He does have lots of strengths. He is very connected with family members. We already get plenty of services.....my questions are more about my attempt to figure out his true diagnosis. I am a chronic over analyzer and worrier.
Thanks for any input.
Chrissy

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Hi Chrissy,
Yes, my 7-year old, typical DD flaps her hands sometimes. I have been told by professionals that it is quite common (my old OT's DS did it too) for a typical child. The cause for concern is if there are OTHER things going on.
Chewing. Yeah, that's commonly a PDD behavior. My 4-year old PDD-NOS DS does it. You have the right idea getting him something else to chew on. Try crunchy/chewy/spicy foods, also, to give him more "bang for the buck."
Scripting. What you're describing is echolalia. That is a common ASD behavior. I don't know any typicals who do that (they don't have the memory for it!)
Have you taken the quiz at:
http://www.childbrain.com/pddq6.shtml
You might see if you recognize some other behaviors.
It sounds like you are on the right track with lots of support. But I know what it's like to analyze and analyze again, wanting answers. If your DS has a speech delay (and it sounds like he does, based on the dyspraxia) then he wouldn't get an Asperger's dx. (by definition an Aspie has non-delayed speech).
Good luck to you and DS,
Cathy
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Cathy,
Actually my son could be dx Aspergers with dyspraxia as a co-diagnosis, or so I have been told. I also read that the criteria for Asp. is no clinically significant language delay, single words by two and phrases by three which my son has done. It surprised me to read that because I think of Asp. kids as usually being advanced in their language dev. I also thought of my son's lang. delay as being severe, but apparently it doesn't meet the standard for "clinically significant".
I can't figure out if the scripting is actually echolalia. I always thought that was more of nonsense talk, or saying it over and over and over.
The flapping thing is really disturbing me lately. I am going to try and get him to substitute clapping. What a puzzle! Thanks for your input.
Chrissy
Hmm...That opens a whole new can of worms for me and my (dx. PDD-NOS) DS, b/c he had single words by 12 months, 2-word phrases by 21 months and sentences by age three.
Cathy
Hi Chrissy,
I have a question as to who dx'd the apraxia as there is quite a bit of controversy regarding the criteria.
Hi,
Thank you for your response. Two developmental pediatricans (at two different practices) dx the dyspraxia. He was last seen in Dec. 04. The dr. also said that weakness in executive function can come along with the dyspraxia, and that results in difficulty monitoring attention, reading social cues, etc.
His speech therapist does not believe the "scripting" is echolalia. Maybe she is wrong? I know there are different types of echolalia.
Examples for you...Two things I often hear my son do are repeat a question someone asks him, rather than answering it. If I prompt him (answer the question and give long wait time, he will sometimes then answer, so not sure if that is his way of processing or what. He also will say things not appropriate for context.....so you might be playing a game with him, and he will suddenly recite a segment from a favorite show or book. He will also do that if he is bored...riding in the car or eating. Obviously that is what is going through his mind at that moment. He will also do something like pick up a play phone and recite a segment from Bob the Builder where Bob talks on the phone. Or play with his Thomas the Train and recite a dialogue from that show. He does some creative play of his own with the figures or trains, but it is limited. I am not sure if that is due to the motor issues (easier to say something you've practiced) or if it is a spectrum issue. It is all so confusing!
I go back and forth between being convinced he is on the spectrum (somewhere) and will be later diagnosed when things become more clear.....and being convinced that he is more typical than not. I hate the roller coaster feeling and I drive my husband crazy with it.
Does anyone have advice on how to cope/ take things one day at a time? I am not good at that....always trying to analyze things to death. My husband says it doesn't matter what the dx is as we are getting him all the help we possibly can.
Chrissy
I recognize some of the things in your post in both my sons - but we are dealing with 2 difference circumstances here, so maybe I have a bit of perspective on the line between Aspergers and other things....
Our oldest (my step son) is 13 and was diagnosed with Apergers at 6. Our youngest is 5, and does not fall on the autistic spectrum but is diagnosed with 10 very severe sensory integration problems and 4 moderately severe.
Regarding language:
The 13 year old was pretty much normal in development except that in his meanings he was/is always very very literal (which obviously causes some communication interface problems with "typical" society)
The 5 year old was/is EXTREMELY advanced in actual vocabulary, subtle use of humor, structure, etc.
The 13 year old would "echo" lines from movies he liked. When he did this, it did not necessarily fit contextually into the conversation or situation at the time. It was/is kind of a "stimulation" thing. It is also often repeated after he hears it. This is echolalia.
The 5 year old remembers every single thing that he ever hears - no matter the source - and then uses it appropriately in context and to his communication advantage. This is not echolalia. For example - he saw a hot rod the other day and yelled out the window to the very "tough" looking guy "Hey man, sweet ride you've got there." You can imagine the look on his face when a 5 year old said this - I think he got it as a line from a movie.
Regarding flapping:
Both our boys do this. It is a sensory integration thing. It provides proprioceptive input to the brain which helps them to calm down and organize their thoughts.
Both our boys also tend to swing their entire arms for the same reason. (Motion doesn't always stay in the hands).
Our 5 year old is MUCH WORSE about this than the 13 year old.
Regarding chewing:
Again, both boys do this - clothes, objects, finger nails, teeth grinding too. This oral input is also proprioceptive and does same things as above.
Again, the 5 year old is much worse.
Regarding reading:
Both boys had/have eye tracking problems at 5, and would not be considered early readers although they both seem to have high IQs. The 13 year old just read the new Harry Potter in 2 nights (600 something pages). Although he reads very quickly, he will not score well on interpretations of what he has read. He retains specific interesting pieces but not retain a general internalized impression of the meaning.
Regarding sleeping:
Both boys have very serious quirks about bed-time and sleeping.
The 13 year old can olny sleep with one specific comforter (it is correct weight and texture). This is a sensory thing.
The 5 year old has a hard time calming his body down to sleep, and must be on either a very hard surface or smashed up against a person or the cushions on our couch. This is also a sensory thing - and heaven help you have his head turned the wrong way. I think it has to do with the light hitting his eyes, again a sensory thing.
Rigidity:
Both boys are rigid and require routines.
The 13 year old requires everything in life to follow his own literal rules and when it doesn't he has a hard time emotionally, and even seems unable to grasp how it could not follow his rules. You cannot talk to him about changing something he expects is a rule.
The 5 year old is comfortable with total flexibilty and unplanned actions - as long as the environment is one that is "safe" for his sensory issues (not loud, not bright lights, not too much movement of other people). Although the 13 year old has quirky rules and requirements, it's kind of a constant thing. With the 5 year old, his emotional responses to "dangerous" sensory stimuli vary with circustances and can actually be far worse than the 13 year old's. When the 5 year old is out of his routine and emotionally over-wrought, you can bring him back to earth with one of his sensory input tools (brushing, rocking, jumping, etc.) Once the 13 year old is gone, he's pretty much gone.
"Traditional" Intelligence:
The 13 year old has a profound gift for math, especially spatial things. At age 7 he wrote a list of the powers of 2 into the billions - and did it all in his head.
His IQ only tests in the 130 range, though testing him is pretty darn difficult.
The 5 year old seems extremely advanced in most areas - it's a more general thing (well, except that he can build electronic circuits and made me a barometer the other day with a balloon...). His IQ tests over 160 but we haven't tried for the more specific #. I think both boys are probably both very gifted, but one is more able to communicate and more easy to test.
Eating:
Both boys have issues regarding the temperature and texture of food. But,
The 13 year old is addicted to, and would gladly limit his diet to bread, pasta (no sauce) and American cheese.
The 5 year old will eat a varied diet and appreciates many more "grown-up" foods. Variety is a good thing for him - but he craves strong sour flavors and salt. He sucks on lemons and eats them...and I am hard pressed to keep pickles in the house. These are sensory issues.
I suspect the wheat/cheese thing is MORE than a sensory issue with the 13 year old. I hear too many parents of autistic kids saying this is all their kids will eat.
So, anyway, don't think that the sensory integration things such as flapping and chewing are what lead to the ASP diagnosis.....they are certainly a component of, because as we have been told most autistic people have sensory integration issues as a component of their make-up. But, sensory things can stand on their own or co-morbid with other diagnosis as well.
HTH,
Jackie
Jackie,
WOW. Your post was so informative and helpful. It was also interesting as I see my little guy in both of your boys. My son does receive OT and it has been noted that he has some sensory issues. I think they are fairly mild. I had not even thought of the fact that the flapping and chewing could be sensory stuff. I am going to get the out of sync book from the library again. My son's spec. ed school does not do the sensory stuff. His former (home based) OT did brushing with him, but I never noticed a difference. Do you know of any other books/resources that teach about the sensory integration thing? That stuff has really helped your boys?
My son has control issues - likes to be in charge and is strong willed. He does fine with changes in routine in terms of our daily schedule or visiting new places. He is however difficult to control in public places (runs around, extremely rambunctious, hasn't reached the age where I can reason with him). So we will go places like the mall, park, or grocery store, but there are places I avoid....say an outing of miniature golf with my ds and NT dd (age 5). He would be a nightmare at something like that. His energy level is endless.
He doesn't like change in small things, say like getting a new pair of shoes. He will fuss but will adapt and accept it when I don't give in. He has numerous difficulties with expressive language but has made HUGE gains. He still uses mostly rehearsed language (learned in speech) but uses it appropriately and in various contexts. This could be partly due to the weak motor planning or not.
I became aware that he could read at the age of three, when his speech became clear. I used to teach reading though, so I have to say he has had lots of stimulation in that area, although not direct instruction.
He is a limited eater - mostly pbj, pancakes, muffins, cereal, french toast, grilled cheese, hot dogs, any type of cracker, bananas and yogurt. No veggies, candy, or meat, although I must add that he had swallowing issues as a young baby and would vomit fruits and veggies. I wonder if he learned to avoid them. He does not try new foods for the most part. Drinks lots of milk.
I've been potty training for a week and a half, and he is more successful than I anticipated him being. At home, he will go #1 in the potty as long as I don't have too many clothes on him (trouble getting own pants off) and he finally did it at preschool today.
The echoing thing really bothers me. He also has weak eye contact. His dev. ped. said it is not PDD because when Evan disconnects socially it is willful. But that was 7 months ago and he wasn't repeating then...didn't have the language to. Wasn't flapping at that time either. He will interact with adults sometimes, but I don't feel as much as a NT child.
He is very connected and joyful with family members. He attempts to interact with neighborhood children but they are mostly older, here to play with dd. He is especially eager to join into crazy or rough types of play...thinks nothing of climbing into a bouncy house full of big kids.
He has a complete breakdown if someone loses their cool and yells at him. I think he can't process the emotions or language and gets overwhelmed. He does have difficulty calming down at these rare times. I have to hug, hold, kiss, etc.
It could be that he has a mix of dyspraxia, sensory dysfunction, immaturity and ADHD and not Aspergers. I know I need to stop trying to figure it out but I can't as I am an answers kind of gal. :) My husband says it doesn't matter as we are giving him every available service, and our school district is generous with services, even without a label. He is probably right.
Thank you so much for all the info. You really helped!
Chrissy
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